Evaulation of ventilator associated pneumonia surveillance data obtained In Medical Intensive Care Unit of Gaziantep University Medical Faculty

Ventilator associated pneumonia is an important nosocomial infection which is prevalant in mechanically ventilated patients. This study was conducted with the aim of exploring infection rate, etiological agents, antibiotic susceptibilities of etiological agents and risk factors for the development of infection in ventilator associated pneumonias in Medical Intensive Care Unit of our hospital.Between January 2007-December 2008, in Medical Intensive Care Unit of Gaziantep University Medical Faculty, a total of 280 cases, developing ventilator associated pneumonia and not who were older than 16 years and had received invasive mechanical ventilation for 48 hours or longer were included in the study. Of 280 cases, whereas 130 who developed ventilator associated pneumonia were involved in the patient group, 150 who didn?t comprised the control group. All patients who were diagnosed with ventilator associated pneumonia were used to calculate the incidence density of ventilator associated pneumonia for the periods of 2007 January-December and 2008 January-December.In multivariate logistic regression analysis, APACHE 2 score more than 20 (p=0.000), the application of non-invasive mechanical ventilation in intensive care unit before the start of mechanical ventilation and the unit where the patients were hospitalized prior to intensive care unit admission (p=0.030), coma-stupor status (p=0.000), transportation out of intensive care unit (p=0.000), reentubation (p=0.015), presence of other non-pulmonary nosocomial infections (p=0.034), tracheostomy (p=0.000), central parenteral nutrition (p=0.020) and nasoenteral nutrition (p=0.000) over the period of mechanical ventilation, before the development of ventilator associated pneumonia in intensive care unit, were estimated as independent risk factors for ventilator associated pneumonia. The incidence density of ventilator associated pneumonia for 2007 and 2008 years were found as 38.1/1000 and 37.7/1000 ventilator days, respectively. The most frequently identified 3 pathogens in cases who developed ventilator associated pneumonia were ranked as Acinetobacter baumannii (36.6%), Pseudomonas aeruginosa (20%) and Staphylococcus aureus (16.6%). The majority of non-fermentative Gram negative bacteria were multidrug-resistant. The predominant pathogen of Gram positives was detected as methyciline-resistant Staphylococcus aureus.In conclusion; under the guidance of these surveillance data identified above, by providing the development of more effective infection control and treatment strategies in our hospital, it is aimed to minimize ventilator associated pneumonia prevalance in Medical Intensive Care Unit and negative impacts of ventilator associated pneumonia, also recognize high risk patients for infection earlier and be able to deliver appropriate antimicrobial therapies promptly to them.Key words: Ventilator associated pneumonia, Intensive Care Unit, Risk Factors